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Recovery of the Cardiac Adrenergic Nervous System After Long-Term ß-Blocker Therapy in Idiopathic Dilated Cardiomyopathy: Assessment by Increase in Myocardial ¹²³I-Metaiodobenzylguanidine Uptake

Department of Internal Medicine III (Cardiology, Angiology, and Intensive Care Medicine) and Department of Nuclear Medicine, Friedrich-Schiller-University, Jena, Germany

View larger version (95K): [in a new window]   FIGURE 1. 123I-MIBG images obtained from short-axis reconstruction in patient with IDC. The M/C ratio reflecting myocardial 123I-MIBG uptake increased from 2.4 before treatment to 3.6 after treatment with ß-blocker (bisoprolol) for about 1 y. C = left ventricular cavity; M = myocardium.

View larger version (22K): [in a new window]   FIGURE 2. Changes in 123I-MIBG M/C ratio (A), LVEF (B), LVEDD (C), and New York Heart Association (NYHA) functional class (D) under ß-blocker therapy for 1 y. Individual data points for each patient and mean values ± SD of four parameters measured at entry and after 1 y of treatment with ß-blockers are shown.

View larger version (16K): [in a new window]   FIGURE 3. Individual course of LVEF and M/C ratio of patients shows good relationship between changes in LVEF (LVEF at follow-up examination - LVEF at baseline) and 123I-MIBG M/C ratio after 1 y of therapy with ß-blockers. In one patient (*), LVEF remained unchanged at 40%, and M/C ratio only increased from 3.12 to 3.18. In another patient (**), LVEF showed small decrease in LVEF from 35% to 30% and in M/C ratio from 2.26 to 2.17. In the remaining eight patients, ascending lines indicate simultaneous increase in LVEF and in M/C ratio.